My first code

[mikie]

_______//\\/\/\/\/\/\/\/\\________/\/\/\/\/\/\/

uh oh...I'm seeing runs of V-Tach! They're alive again (like in the movies/tv)!!

 

[firecoins]

_______//\\/\/\/\/\/\/\/\\________/\/\/\/\/\/\/

uh oh...I'm seeing runs of V-Tach! They're alive again (like in the movies/tv)!!

Well the thread is cured. Well discharge immediatly.

 

[mikie]

Well the thread is cured. Well discharge immediatly.

I was anticipating a shock!

 

[MedicPrincess]

MissTrish- I was once beating myself up for the outcome of a pt. An OLD (yep, I said it... OLD as in over 40) Medic looked at me and said

"Is there anything YOU could have done different that may have changed the outcome of the patient? No, then stop being such a sissy!"

Now, I am not calling you a sissy....but the point he was so delicatley making was, the patient is dead. She did it to herself. Its called Lifestyle choices. There are consequences.

I don't tend to dwell on my patients outcomes. I have only gone back and checked on less than a handful of patients. I just move on. One of my very best friends, MUST go back and check on patients. I have accompanied her to the ME's office while she found out what made a patient, who was CAOx4, code in front of us. It helps her to have her "closure."

You have to find out what works for you. Exercise, play with your kids, take a long nap, stand in a field and scream, talk to your partner, get a couselor if you have to. If you are going to make it any length of time, you have to find your coping mechanism.

Yesterday 04:36 PMfirecoinsI am sorry but I was presented with a valid DNR.

You see.... the problem is.... Your DNR is not valid for me. Sorry. Haven't had a code or intubation in a while, I'm jumping all over the next chance I get

I don't care how many codes you have worked, how long you've been in Emergency Medicine or what your pedigree is. This is the most callous insensitive load of smoke I have ever heard from anyone in healthcare. In the absence of a DNR, regardless of the present response to therapy, you work them til the end with your full attention and ability PERIOD. You do not lose your focus and you darn sure dont relax.

Why not relax? Would you rather the provider working on your mother/father/sister/brother/whatever be wound so tight they could turn coal to diamonds? A code is a code. You do compressions, you bag them, treat the rhythms as they present. You can still talk to the people around you, giving direction, finding out information, ect and still be effective.

If you are relaxed while doing it, and not stressed out and wound up, it will go smoother. Even if you work it and call it on the patients living room floor with family standing there.

 

[ride2k]

I witnessed my first code while I was riding with the ambulance service I belong to. I didn't have any certifications (I'm almost done with class for EMT-B at this point) and I was standing in the back watching everything. The guy coded in the back and there was a paramedic and two EMT's with me watching.

Fortunatly, everything happened quick. He coded while he was hooked up to the medic's heart monitor, and 2 person CPR was started quickly. Shortly after, the medic was ready to intubate.

We never found out what caused this to happen, for when we walked into the house, we were suspecting possible stroke, which was not the case. But we did get a letter a month or so later from the wife, saying that this guy had survived. He beat the odds, and I'm glad to say I was there to witness his survival.

 

[emt19723]

i was fortunate enough that we saved my first code. so that kinda made it a little easier when i did lose my first one.

but i gotta go along with everyone else....the really morbid senses of humor we develop is definitely a defense mechanism. if you cant develop one, you are doomed in this field.
and sometimes docs make the call and we dont like it. you just gotta keep your head high, and be satisfied knowing that you did everything in your knowledge and power as per protocols that you did all that you could. just do it a little better the next time and get the next one back and hopefully that same doc will be there to treat that pt and you can stick your tongue out at him!

 

[emtd29]

Trish,

People die. It's inevitable.

One thing you will learn is that you cannot win them all

 

[BossyCow]

My first code also survived. When I left the ER the doc was having the 'it's time to make some decisions' talk with the family. I went on 4 more calls with that lady. Blind, stroked out, in her 90's, living in an adult foster home, no kids, grandkids just a distant great-niece who never visited by made the decisions for her care.

 

[emt_angel25]

the first code is always the hardest. it gets easier but its still pretty hard to know that you tried with all your might and someone still didnt live. you have got to be able to seperate your self from the "calls you run" or this job will burn you out. its tough and i know that my first code was almost 5 yrs after i got my liscense. you got lucky so to speak you got to experience something so dramatic so early. so you can ask your self "is this really for me" i dont know if i was helpful or not but dont beat yourself up cause there was nothing you could do to change the coarse of fate. its life you will never get out alive. losing a pt is rough but being there for a code when they survive makes it all worth while.

 

[Aileana]

Everyone's first code seems to carry a lot more emotion than all the following ones. It's if every code induces that sort of response, you might want to reconsider.

My first code, I remember every little detail still (and probably will through my whole career). Got him shockable, but it just didn't take. I remember in the hospital, the nurses were laughing because they had to bring me a stool to do my compressions from (I'm 5'1). Dark humour is a big part in emergency services, guess it helps with coping. After the patient was pronounced, I remember looking at him and saying 'goodnight', then going back to paperwork.

But just remember (as pretty much everyone else has said), people live and people die. Life wouldn't be possible without death. As long as you did your best, stop second-guessing yourself. No matter how great one is treated, it doesn't guarantee a bring-back; the result doesn't necessarily reflect the effort.

In EMS you will lose patients, it's just a fact of the job. Hopefully the next codes aren't as emotional for you

 

[Jeremy89]

I remember in the hospital, the nurses were laughing because they had to bring me a stool to do my compressions from (I'm 5'1)

I'm 5'11" and they still had me use a stool. I think just for better leverage.